In endoscopic surgical interventions, such as in laparoscopy, it is customary to create several points of access to the operating area in order to convey medical instruments, such as for instance cutting and/or gripping instruments for performing the operation, to the operating area by at least one means of access and to convey an observation unit, such as an endoscope for observing and guiding the operation, by at least one additional means of access.
However, if the operating area is very limited and small, as is the case for instance in operations of the bladder, it is impossible to convey the observation unit into the operating area by a separate means of access.
For these purposes, DE 202 04 691 U1, for instance, teaches inserting the optical observation unit together with a morcellator into the hollow shaft of an additional medical instrument, such as a resectoscope. In this instrument configuration known from the art, the optical observation unit consisting of a viewing canal and light cables is structured in the shape of a sickle and positioned in the resectoscope contiguous to the interior wall of the resectoscope shaft in order to create the largest possible working passage for the morcellator that is likewise inserted into the hollow resectoscope shaft. Although this instrument arrangement known in the art has proved itself in practice, it is also true that the arrangement of the optical observation unit and of the morcellator in the resectoscope shaft requires a small diameter for the morcellator cutting blade. It is therefore a disadvantage of this known arrangement that using a small cutting blade in morcellating large tissue areas requiring morcellation can last quite a long time.
In addition, WO 99/07295 A1 teaches a system for surgical removal of tissue consisting of a morcellator and gripping instrument that can be inserted into the hollow shaft of the morcellator. For operating, the morcellator is inserted directly into the artificial bodily opening so that the external mantle surface of the morcellator shaft provides insulation for the patient.